Tilapia is a traditional dish in most countries of Sub-Saharan Africa (SSA). A deadly disease caused by a virus named Tilapia Lake Virus (TiLV) currently threatens tilapia production and fisheries. The objective of this study was to describe TiLV disease, discuss its related socio-economic impacts in SSA, and envisage preventive measures applicable in SSA countries. The methodology was based on an exhaustive search on TiLV in PubMed, Web of Science, Scopus, Google Scholar and ResearchGate. Results revealed that TiLV is an RNA virus causing the disease of up to 90% mortalities in tilapia. It affects all developmental stages, however, tilapia fingerlings and juveniles seem to be more vulnerable. TiLV is transmitted horizontally between infected and naïve fish in the aquatic environment and is a potential trade-influencing transboundary animal disease. The disease is currently confirmed in eight countries such as Ecuador, Israel, Colombia, Egypt, Thailand and Taiwan, India and Malaysia. However, subclinical infections have been detected in the Tanzanian and Ugandan basins of Lake Victoria. Reports show that at least 10 SSA countries have likely imported TiLV infected tilapia fries and fingerlings from hatcheries in Thailand whereby Burundi, Congo, Mozambique, Nigeria, Rwanda, South Africa, Togo, Zambia, Tanzania and Uganda are now suspected infected with TiLV with the two latter recently confirmed. SSA is a newly reported region of TiLV circulation and all tilapia farming countries in the region may have theoretical risk of infection. It poses a major threat to fish supplies and the nutritional status in populations that eat tilapia on a regular basis and likely constitutes a food security issue. Over 150,000 tons of tilapia from tilapia farming and more from the tilapia fisheries with their associated costs could be threatened in SSA due to TiLV. Some control measures recommended by OIE and FAO may not be practical for countries in SSA region, and farmers can hardly comply with biosecurity measures or afford vaccination unless vaccines are thermostable, require no sophisticated technology for administration and are cost-effective to small-scale rural farmers. There is a crucial need for capacity building among farmers and technical personnel on diagnostic procedures and effective remedial action, creation of awareness among farmers on TiLV management and establishment of diagnostic and outbreak response systems. We encourage the creation of a Community-Based Fish Health Insurance funds (CBFHI) among small-scale fish farmers for outbreak prevention and control at local levels.